The medico-legal investigation of sudden, unexpected and/or unexplained infant deaths in South Africa : where are we-and where are we going

Abstract:

Sudden Infant Death Syndrome (SIDS) has been
reported to be the leading cause of death in infants under
1 year of age in many countries. Unfortunately, a paucity of
published research data exists in South Africa, with regard to
the incidence of and investigation into the circumstances
surrounding Sudden Unexplained Deaths in Infants (SUDI)
and/or SIDS. Currently, even though most academic centers
conform to a protocol consistent with internationally
accepted standards, there exists no nationally accepted
infant death investigation protocol in South Africa. It is the
aim of this study to review the current practice of infant
death investigation in two representative but geographically
and demographically distinct centers. Retrospective case
audit over a five-year period (2000–2004) was conducted at
two large medico-legal mortuaries in Pretoria (Gauteng) and
Tygerberg (Cape Town). Case files on all infants younger
than 1 year of age were reviewed. The outcome measures
included number of deaths, demographic details and the
nature and final outcome of the post mortem examinations.
A total of 512 cases were identified as possible SIDS cases
and of these, 171 was classified as SIDS. The study showed
marked inter-case and inter-divisional variation in terms of
the investigation of infant deaths at the two institutions. It is
envisaged that this study will focus attention on the current
lack of usable data regarding sudden/unexplained/unexpected
infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally
accountable) infant death investigation protocol,
which could facilitate comparisons with other countries and
initiate further structured research in this field.